Follow

Patient Payments And Statements

Payment Posting (Manual & Electronic) We ensure prompt and accurate posting of payments and adjustments, whether received through Electronic Remittance Advice (ERA) or traditional paper EOBs. This process is essential for maintaining up-to-date patient and payer account balances and ensuring smooth cash flow.

1. Zero-payment and Short-pay Identification: We flag and investigate claims that result in no payment or are underpaid to address issues quickly and minimize revenue loss.

2. Automated ERA Integration and Remittance Logic : Our systems automate payment posting by interpreting ERA data accurately, reducing manual work and posting errors.

3. Cross-checks with Fee Schedules and Contracts: Every payment is validated against agreed-upon rates to ensure compliance and to identify potential underpayments for timely follow-up.

Planning and sketching

Modern and unique design practically point of view, it risks not meeting the huge expectations

Team working

Modern and unique design practically point of view, it risks not meeting the huge expectations

Flowchart and wireframe

Modern and unique design practically point of view, it risks not meeting the huge expectations

User experience Testing

Modern and unique design practically point of view, it risks not meeting the huge expectations

ACA Commercial Risk Adjustment Coding

We support accurate and compliant risk adjustment coding for Affordable Care Act (ACA) exchange-based plans by capturing all eligible diagnoses that impact a member’s Risk Adjustment Factor (RAF) score. Our certified coders conduct thorough medical record reviews and detailed abstraction to identify and document all relevant chronic and high-impact conditions. By aligning with HHS-HCC risk models and payer-specific requirements, we help health plans enhance RAF scores, ensure appropriate premium transfers, and maintain compliance with regulatory standards—ultimately supporting both financial performance and care quality.